- Medicare Primary Care in Jacksonville, FL

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is a medicare enrolled primary clinic (Family Medicine) in Jacksonville, Florida. The current practice location for is 4348 Southpoint Blvd, Ste. 100, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 281-1915. The mailing address for is Po Box 639295 Dept 40599, Cincinnati, Ohio and phone number is (248) 824-6600.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1750787982. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (904) 281-1915.

Contact Information

4348 Southpoint Blvd
Ste. 100
Jacksonville
FL 32216-0986
(904) 281-1915
(904) 281-1119

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityFamily Medicine
Location4348 Southpoint Blvd, Jacksonville, Florida
Authorized Official Name and PositionZachary Mulligan (CFO)
Authorized Official Contact2488246600
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

Po Box 639295 Dept 40599
Cincinnati
OH 45263-9295

Ph: (248) 824-6600
4348 Southpoint Blvd
Ste. 100
Jacksonville
FL 32216-0986

Ph: (904) 281-1915

NPI Details:

NPI Number1750787982
Provider Enumeration Date11/17/2014
Last Update Date08/30/2022

Medicare PECOS Information:

Medicare PECOS PAC ID6507182409
Medicare Enrollment IDO20150312001580

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1750787982NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameBhavesh S Patel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1679549232
PECOS PAC ID: 0749172344
Enrollment ID: I20040329000148
Provider NameShaynee S. Golin
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1598704447
PECOS PAC ID: 2466410824
Enrollment ID: I20041231000012
Provider NameArnel Larcia
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1689640427
PECOS PAC ID: 7315959921
Enrollment ID: I20060623000227
Provider NameTammy N Thaggert
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1174534770
PECOS PAC ID: 9032119490
Enrollment ID: I20070109000115
Provider NameElyse Beaubrun
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396971305
PECOS PAC ID: 4385790948
Enrollment ID: I20090923000236
Provider NameDiana C Maccario
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1205007036
PECOS PAC ID: 5799826905
Enrollment ID: I20100111000365
Provider NameJohn Paul Guercio
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1306850441
PECOS PAC ID: 2264563931
Enrollment ID: I20100623000906
Provider NameNannette B Hoffman
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1568406734
PECOS PAC ID: 1658565890
Enrollment ID: I20101101001173
Provider NameElizabeth Schultz
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1770583577
PECOS PAC ID: 9537158217
Enrollment ID: I20110128000595
Provider NameGuilad Pribluda
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1356516843
PECOS PAC ID: 9436328242
Enrollment ID: I20110812000316
Provider NameMary Kae Sandidge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124395272
PECOS PAC ID: 9830358654
Enrollment ID: I20120313000910
Provider NameRebecca K Reza
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023360435
PECOS PAC ID: 9537486808
Enrollment ID: I20150325001404
Provider NameStephanie Nicole Burkhalter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386027332
PECOS PAC ID: 5092028779
Enrollment ID: I20150723009626
Provider NameGloria Calderon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568833804
PECOS PAC ID: 6406166149
Enrollment ID: I20151109000377
Provider NameNikita Mcmiller Richardson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992177349
PECOS PAC ID: 6608176185
Enrollment ID: I20151207000847
Provider NameJessica Lynn Burkett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023495801
PECOS PAC ID: 0143527267
Enrollment ID: I20160404001965
Provider NameIlze Hicks
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1619337532
PECOS PAC ID: 4385941475
Enrollment ID: I20160405001743
Provider NameKelly Bingham Traylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710341557
PECOS PAC ID: 2769781947
Enrollment ID: I20160422001594
Provider NamePeri Sert
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1699072256
PECOS PAC ID: 6901105683
Enrollment ID: I20160502000850
Provider NameJermaine A Campbell
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1407017387
PECOS PAC ID: 0840599551
Enrollment ID: I20160502001788
Provider NameLashaniqua Howard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922454586
PECOS PAC ID: 7618260183
Enrollment ID: I20160720002061
Provider NameLourdine Jean-baptiste
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730536632
PECOS PAC ID: 8022396860
Enrollment ID: I20161028000756
Provider NameRakesh Ravikumaran Nair
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1730529041
PECOS PAC ID: 9931402559
Enrollment ID: I20161115000185
Provider NameAustin Moody
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1881004299
PECOS PAC ID: 6406072255
Enrollment ID: I20170722000310
Provider NameRenette Charles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205284155
PECOS PAC ID: 0446545107
Enrollment ID: I20170821000884
Provider NameChristopher B Howard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891212973
PECOS PAC ID: 1456627975
Enrollment ID: I20171026003458
Provider NameSusan Wolfe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336689470
PECOS PAC ID: 8123386968
Enrollment ID: I20171227001680
Provider NameCarrie Gilliam Baker
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1629146915
PECOS PAC ID: 7719102805
Enrollment ID: I20180109001138
Provider NameMena Hanna
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1952798258
PECOS PAC ID: 7719241116
Enrollment ID: I20180511001542
Provider NameJudy Ann Alonso-slusarz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194297291
PECOS PAC ID: 5991042285
Enrollment ID: I20190124001195
Provider NameRhea Vergara Ambray
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760943500
PECOS PAC ID: 0749523413
Enrollment ID: I20190521000395
Provider NameTamara Lynette Dukes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821606229
PECOS PAC ID: 4486065638
Enrollment ID: I20201119002796
Provider NameErica Ebohon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801430715
PECOS PAC ID: 8022441757
Enrollment ID: I20220708000227
Provider NameJennifer Datzko
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568005569
PECOS PAC ID: 3870825326
Enrollment ID: I20240102002205
Provider NameEunice Yu
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1356607881
PECOS PAC ID: 2264681204
Enrollment ID: I20240213004196
Provider NameNitish Kosaraju
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1184815383
PECOS PAC ID: 7012063886
Enrollment ID: I20240308003429
Provider NameRupen Amin
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1376709493
PECOS PAC ID: 9234313933
Enrollment ID: I20240319000474

Reviews and Comments


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Medicare: Not Enrolled in Medicare
Practice Location: 3160 Edgewood Ave W, Jacksonville, FL 32209
Phone: 904-768-8222    Fax: 904-482-0373

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.